HomeMy Public PortalAbout5129 CAMELLIA AVE_Electrical__ 76A663-CES06 3-64 APPLICATION FOR ECECTRICAL AC Mft r,I'n�III
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING K/ A rj
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY
-
NEAREST J
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO. EACH FEE !�
OUTLETS FIRST 20 ffi 20 $ OWNER
LIGHT MAIL
ADD'L 1O ADDRESS
SWITCH. OVER 20
LIGHTING TOTAL FIRST 20 20 CITY TEL. NO. A:�FIXTURES ADD'L 1DELECTRICI N
OV R 20
CLO.DRYERS WTR.HTRS. 1.00 `�� ADDRESSQ.GA . ISP. STA.COOK 799CITY q TEL.NO. ! TDISHWASH. AUTO.-WASH. STA E
SPACE HTRS. STA.APP.(I/.H.P.MAX.) ,50 LICENSE NO.
MOTORS: ovER NorovER H.P. DIS IC O. GROUP ZONE P
O 1 1.00
I s 1.50 INSPECTION RECORD }
CL
s s 2.00 O
8 15 2.50
18 50 3.00 0
' V
50 100 5.00 W
NO.TRANS - Z
SIGNS: NO.LAMPS •i •''w'� 1' J .
SERVICE 0.60OV-NOT OVER 200A 1.00
SERVICE 0-60OV-OVER 200 A. 2.00 1
SERVICE OVER 600V 5.00
MISC.
I�
PERMIT ISSUING FEE 2.00
SUPPLEMENTAFtY PERMIT ISSUING FEE 1.00
TOTAL FEE >i
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INBPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _ -
ELECTRICAL WIRING.
WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTE �f
FINAL
CCKLIDATION ARTHUR C. VEIT
�MO CASH SUPERVISING ELECTRICAL ENGINEER
&� L
7EA663.CffW5 4.65 APPLICATION FOR ELECT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING �� �E
BUILDING AND SAFETY DIVISION ssa
ADDR
JOHN A. LAMBIE..COUNTY ENGINEER
COLEMAN-W. JENKINS. SUPT. OR BUILDING LOCALITY EMPLL� C/
MR AMI-CANT TO FILL I cRose ti-r. ,,pp
RSC SPTACLE TOTALFIRfT 20 NO. ;O s Fu OWNER /� 1. EIlD�E W
LIGHT OUTIHTB /�j MAIL
SWITCH ADD'L ADDRZM 5'/7 /Q
CA MELL! /4V,5'.
OVER AQ .10 ,C/� /�
TOTAL FIRST 20 .IIO cITM `� `� Td. NO.Z 6- 7-VX Y
LIGHTING PIXTU REf -
FIXTURES ADD•L
1—.OVXR 20 -10— CONTRACTOR �/IvE
RANG" CLO.DRYERS WTII.HTR•. 1.00 ADDREBS
GLARE.DISP. STA.COOK
CITY TEL No.
DISHWASH, AUTO-WASH. STATZ
SPACE HTR•. STA.ATT.(Y.H.P.MAX.) ,ao LICENSE NO.
MOTORS, ovER NOT OVER H.T. DISTRICT O. d P Z E PRO,WtBSED
0 1 1.00
1 a 1.eo INSPECTION RECORD
3 6 2.00
s 1e i.eo
10 GO 3.00
as 100 15.00
U
SIGNS. NO.TRANS,
NO.LAMPS
SERVICE 0-e00V-NOT OVER 200A 1.00 ✓
SERVICE 0-E0oV-0VER 200 A. 2.00 _
SZRVICK OV16i COOV 11.00
OTHER (SEE COMFLrT[ FE[SCHEDULE)
FSRMIT ISSUING FEZ 2.00
SUFPLZMENTAQY PZRMIT IWUMQ FZZ 1.00
TOTAL FEE r DATE lmmm=rcotlg 91614
I H[RrnY ACKNOWLEDGE THAT 1 HAVE READ THIS ATPLICATION UNDERSLAD WORK
AND STATE THAT THE Al!lOV[ 12 CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS RIOULATINGL
[L[CTRIUL WIRING. WIRING
I HLI"Y CLRTIFH
Y THAT 1 AM PROPERLY R[GI•TD AND/OR FIXTURES
UC[ E
NSD AS REQUIRED BY LxcI
O• ANGELL[S COUNTY AND STATE OF
CALIFORNIA OR THA 1 AM THE LEGAL OWNER O .AND 1 ND TO rowan
R[•ID[IN,TH[A■ [D[SCAIEED • N L OF
SIGNATURK UTILITY CO-f4cfflrlxp
OF FERMI
FINAL
LIDATION
(CIC`/ SEPH G ROOHAN
YO CASH�G�� SUFERVISING ELZCTRICAL ENGINZZR
j 1 38 8ZB "19 2 D 17A QMcQ
WORKERS'COMPENSATION Drte of coON � ,ae, APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certlflcate of courant to self
Insure, or a certificate of Workers' Compensation Iane, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a cerllf c>j yJhg2pf.P-c. 3800,
Policy No. �L`(yCyompanyPPOR APPLICAM TO Rl IN �'Z
Certified copy Is hereby fumished. New Residential Bldgs. 8 Pool& EACH NO.
��rtlfled copy Is filed with the county bulldln 1 a 2-Famlly, Sq. Ft.
_ _ f LCK:ALTrI'
tion depa ment. Multi-family Sq. Ft. NECROSS
S
Residential Swimming Pools OA
Date Applicant FIRM NAAAE
CERTIFICATE OF EXEMPTIO RKERS' Outlets: Rec2.1LIght�Sw:, L
COMPENSATION INSURANCE ADORE55
First 20
(This section need not be completed If the work Involved by Total No. Additional CITY Tel. No.
the permh Is for one hundred dollars(:100)or less.) PLAN
I certlfy that In the performance of the work for which this
permit Is Issued, I shall not employ any Person In any manner
so as to become-subject to the Workers Compensation Laws. Lighting Fixtures First 2Q ADDRESS
Additional Total No. CITY Tel. No.
Dote ATnlicant Fixed Appliances Not Over 1 HP p7
NOTICE TO APPLICANT: , diter, making this Certificate of A7WLCANf
Exemption, you should become subject to the Work" Range_ Heater_D.W. —
Compensation Provisions of the Labor Code, you must forth- Oven — Dryer — W.M.— ADDRESS
with comply with such provisions or this permit shall be Top FAU —W.H. —
deemed revoked. Hood Fan _Other_ CITY Tel. No.
LICENSED CONTRACTORS DECLARATION,
OR d
1 hereby affirm that I gm Iltbnsed under provisions of Chapter 9 Dlsp. Room Air Cond. REf NUM13ETt� -1 Claes.
(commencing with Section 7000) of DIvi;Ion 3 of the Buslr»as Appliances DISTRICT NO. BY }
and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large
Size 8 Type HP, KW, KVA, or KVAlt' s
11censd Number Ic. Class Up,to 1 Incl. FINAL V
Over 1 to 10 Incl. DATA f 2� VALIDATION 09
Contractor Date Over 10 to,50 Incl. \/
FINAL
❑ I am exemp nder Sec. Over 50 to 100 Inc. BY
a
_ B.aP.C_ for this reason Over 100 s�1
Date: Services, Swbd., MCC a Panelboards ,
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp.-Under 600 V
❑ Over 1000 Amp. or Over 600 V
Exemption for Reg. Malnt. Elect.
SINGLE FAMILY Temp. Power Pole a Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits —4 0 2 2'8'A
Professions Code):
❑
Misc. conduits a Conductors
'# oo o-o 0 2
I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)_ , 2F°i° 1 8 7.5
structureI& not Intended or offered for sale (Section
7044, Busi
ness and Professions Code).
CONSTRUCTION LENDING AGENCY ;°r° ° 1 $7 5•�
I hereby affirm that there Is a construction lending agency for 0 307-83
the performance of the ,work for which this permit is Issued PERMrr FEE (Sub-Total)
(Sec. 3Q97, Cly. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEELender's Address
I certify that I have read this application and state that the TOTAL FEE
above lnformatlon Is correct. I agree to comply with all.County
ordinances and State laws regulc ing Electrical wiring, and
hereby authorize representatives of this County to enter upon
the a men rty for Inspection purposes.
3- � SEE REVERSE FOR EXPLANATORY LANGUAGE
gnat6roLSTof Permittee Dote